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Can A Woman Go Through Menopause Years After A Hysterectomy

Older Women Still Suffer From Hot Flashes And Night Sweats Years After Menopause Study Finds

Menopause After Hysterectomy | How Are They Connected?
Date:
Wiley-Blackwell
Summary:
Women still have hot flashes and night sweats years after menopause, a new study finds. Hot flashes and night sweats are the main physical signs of the menopause, however their prevalence, frequency, severity and duration vary considerably.

Women still have hot flushes and night sweats years after menopause, finds a new study published in BJOG: An International Journal of Obstetrics & Gynaecology.

Hot flushes and night sweats are the main physical signs of the menopause, however their prevalence, frequency, severity and duration vary considerably.

The average age of the menopause in US and European women is 50-51 years and it is generally assumed that HF/NS last between 2 to 5 years.

This study looked at 10,418 postmenopausal women aged between 54 and 65.

The average age of the participating women was 59 and the majority were white, living in urban localities and of slightly above average socioeconomic status.

The study looked at the impact of age, BMI, hysterectomy, hormone therapy use, lifestyle and mood on women’s experience of HF/NS.

The participating women completed a questionnaire, which included sociodemographics, weight and height, and medical history. Three and a half years later, they were sent a follow up questionnaire asking them about lifestyle factors, skirt size at age 20, current skirt size, hot flushes and night sweats and current hormone therapy use.

Sleep Problems And Mood Swings

Try these options to avoid sleep problems:

  • Avoid large meals, smoking, coffee, or caffeine after noon.
  • Avoid napping during the day.
  • Avoid exercise or alcohol close to bedtime.
  • Drink warm milk or warm caffeine-free tea before bed.
  • Sleep in a dark, quiet, and cool room.
  • Treat hot flashes to improve sleep.

Easing stress, eating right, and staying physically active can help with mood swings and sleeping problems. Your doctor may also prescribe medication to help with mood swings.

You should talk to your doctor about managing your symptoms and to rule out other conditions that may be causing your symptoms, like depression or asthma. Its also helpful to join a support group for women in menopause so you have a safe place to share your concerns and issues.

Your doctor may also prescribe menopausal hormone therapy to help treat your symptoms. MHT can ease:

  • hot flashes

Studies show that women who take MHT are at an increased risk of heart attack, stroke, and blood clots. The risks are similar for women using contraceptive pills, patches, and rings. However, women taking MHT are older, and the risks increase with age.

Many women cant take MHT because of a previous illness such as cancer or because they take other medications.

Additional research found that the risk of getting breast cancer can increase with five or more years of continuous MHT use .

Women who have had their uterus removed will use estrogen-only therapy.

Confirming That The Menopause Has Taken Place

Its not always easy to confirm that the menopause has actually happened. Of course, irregular periods and the occasional hot flush are a sign that changes are taking place, but identifying the time of the actual menopause is not so simple, especially if you are taking the Pill or have started Hormone Replacement Therapy for the relief of peri-menopausal symptoms.

The question may seem irrelevant, but it is helpful to know the date of your last period, not only so that you can respond to symptoms in the most appropriate way, but also for contraceptive purposes. A truly menopausal woman will be infertile and will have no need of contraception. However, most doctors advise menopausal women under 50 to continue with their contraception for two years after their last period and for one year if they are over 50.

Most doctors will evaluate a womans menopausal status according to her symptoms , pattern of periods, and medical record. It is possible to take a blood test to measure levels of a reproductive hormone known as FSH. However, while elevated FSH levels may be a sign of the menopause, the test is not always accurate and results cant be guaranteed. Measurement of FSH is not required to diagnose perimenopause or menopause in women aged over 45 years.

This is also the case in those rare instances of premature ovarian Insufficiency, when the hormonal system fails at an early age and the ovaries lose their normal function.

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Menopause Symptoms: Sex Problems

Menopause symptoms can affect sexuality. Along with menopause, women experience lower levels of the hormone estrogen. One of the effects of lowered estrogen levels is a decrease in blood supply to the vagina, which causes vaginal dryness. This can result in painful or uncomfortable intercourse. Water-soluble lubricants can help overcome this problem. If lubricants are not effective, contact your doctor. Vaginal creams and suppositories can be prescribed to ease vaginal dryness.

Another effect of hormonal changes is a change in libido, or sex drive. This may improve or worsen, but it is important to remember that other factors besides menopause can affect libido. Stress, sleep disturbances, medications, and anxiety can all affect sex drive. Your doctor can help you find ways to manage the changes in your sex drive if they occur.

Finally, although fertility ends at menopause, women of all ages are still susceptible to STDs, so safe sex is still important.

What Happens And How Does It Feel

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For some women this loss of reproductive ability may be deeply felt, and for all women the menopause is a personal experience, not just a medical condition. However, the diminishing release of oestrogen from the ovary as women advance into their 40s is often the cause of symptoms which can be distressing and may need medical attention.

Hot flushes are the most common symptom of the menopause, occurring in three in every four menopausal women. Other common symptoms include night sweats, sleeplessness, vaginal dryness, irritated skin, more frequent urinary incontinence and urinary tract infections, low mood and a reduced interest in sex. Symptoms vary hugely in duration, severity and what impact they have on women.

All the common symptoms of the menopause are associated with a decrease in the bodys production of oestrogen. Oestrogen lack can affect many parts of the body, including the brain, causing changes in emotional well-being, and the skin, influencing its elasticity and thickness.

There is also some evidence that oestrogen deficiency is the cause of some chemical changes in the body which make women after the menopause especially vulnerable to heart disease and stroke.

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How Do I Stay Healthy After Menopause

It is important to maintain a healthy lifestyle, especially as you age and your risk for certain medical conditions increases. Some ways for people in postmenopause to stay healthy include:

  • Exercising regularly. Walking, doing yoga or strength training can help lower your risk for many medical conditions.
  • Weight-bearing exercises can strengthen your bones and muscles.
  • Eating a healthy diet. Foods like fruits, vegetables, lean meats and whole grains should make up the bulk of your diet. Avoid lots of salt or sugar and limit your consumption of alcohol.

A note from Cleveland Clinic

Going through menopause can be uncomfortable and present new challenges and health concerns. Speak with your healthcare provider about any symptoms you feel or questions you have. They can help make sure you are supported through this time and get the care you need.

Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.

References

Will You Go Into Premature Menopause

You may have heard that your hormone levels drop after a hysterectomy, but that isnt accurate. Your uterus, cervix, and vagina arent part of your endocrine system, which means theres no effect on your hormones, if they must be removed.

You can have one ovary removed and, as long as it stays healthy, it produces the hormones you need. Its different when both ovaries are removed, however. A bilateral oophorectomy causes an abrupt loss of hormones. As a result, you enter premature menopause.

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Menopause Treatment: Bioidentical Hormone Therapy

The term “bioidentical” hormone therapy has been used to refer to hormones derived from plants prepared individually for patients at compounding pharmacies. Some FDA approved prescription products are also “bioidentical” in the true sense of the word. Some doctors feel that compounded “bioidentical” hormone products are safer, but the US FDA does not approve these products.

A Sudden Loss Of Estrogen In The Body Can Lead To Physical Changes

Can a Hysterectomy Cause Early Menopause?

These changes may include:

Some age-related health issues may include:

  • Cognitive impairment, such as dementia and Parkinsonism
  • Low bone mineral density, which can lead to arthritis and osteoporosis
  • Faster loss of tissue, which connects and supports body functions. This typically is related to aging and linked to heart disease, stroke, depression and anxiety

For those who dont have their ovaries removed, rapid aging symptoms are still possible but may happen less suddenly.

Having a hysterectomy without an oophorectomy may increase the likelihood of eventual ovary failure. Ovary failure causes the decrease in estrogen to happen more gradually meaning associated symptoms also may happen more gradually.

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Is Hormone Replacement A Safe Option For Management Of Menopausal Problems

Several hormone therapies are FDA-approved for treatment of hot flashes and prevention of bone loss. The benefits and risks vary depending on the severity of your hot flashes and bone loss, and your health. These therapies may not be right for you. Talk to your doctor before trying any hormone therapies.

How Will I Know If Im Going Through Menopause If Ive Had A Hysterectomy

If your uterus was surgically removed through a hysterectomy, you may not know youre going through menopause unless you experience hot flashes.

This can also happen if youve had an endometrial ablation and your ovaries werent removed. Endometrial ablation is the removal of the lining of your uterus as treatment for heavy menstruation.

If you arent having any symptoms, a blood test can determine if your ovaries are still functioning. This test can be used to help doctors find out your estrogen level, which may be beneficial if youre at risk of osteoporosis. Thats because knowing your estrogen status may be important in determining whether you need a bone density assessment.

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What You Need To Know About Surgical Menopause

This is part of an ongoing series featuring interviews with physicians on topics related to hereditary cancer. This is a summary of a discussion with Ann L. Steiner, MD, anobstetrician-gynecologist and clinical professor at Penn Medicine. The Symptoms of Surgical MenopauseMenopause is the absence of estrogen. When women stop making estrogen, this can result in several key symptoms. On average, natural menopause occurs around 51 years of age, when periods cease. Menopausal symptoms may begin before the final menstrual period when the loss of estrogen begins gradually. But if a 35 year old woman with regular, monthly periods has her ovaries removed, she is likely to be much more symptomatic then if she had gradually gone into menopause.

Surgical menopause can affect hot flashes and mood, and can increase the rate at which a woman loses bone and may develop osteoporosis. Theres a concern that younger women who go into menopause might be at an increased risk of heart disease later in life. It could also affect cognitive function. If women dont have a history of a cancer that would contraindicate the use of estrogen, such as breast cancer, we discuss giving estrogen, both for symptoms and for potential prevention of these problems.

Endometriotic Mass After Hysterectomy In A 61 Year Old Post

Menopause symptoms: How long do they last?
  • 1Département de Chirurgie Gynécologique et Oncologique, Hôpital Cantonal, Fribourg, Switzerland
  • 2Département de Chirurgie Générale, Hôpital Cantonal, Fribourg, Switzerland
  • 3Département de Radiologie et Radiologie Interventionnelle, Hôpital Cantonal, Fribourg, Switzerland
  • 4Institut de Pathologie, Centre Hospitalier Universitaire Vaudois , Lausanne, Switzerland

Endometriosis is a common, hormone-dependent gynecologic disease. Undiagnosed in large proportion of women, managing therapies depend on the impact of quality of life and includes hormonal treatment and pelvic surgery. Less likely endometriosis can occur in post-menopausal women. Malignant transformation of endometriosis is a rare but well-described process, most of time occurring in the ovary, and justifies the practitioner not to underestimate this pathology. We present a case of a 61 year old woman with a symptomatic endometriotic pelvic mass, status post hysterectomy, with no history of endometriosis diagnosed beforehand.

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When Should I Call My Doctor

If any of your postmenopause symptoms bother you or prevent you from living your daily life, contact your healthcare provider to discuss possible treatment. They can confirm you have completed menopause and are in postmenopause.

Some questions you might ask are:

  • Are these symptoms normal for people in postmenopause?
  • Is there treatment for my symptoms?
  • Is hormone therapy still an option?
  • What can I do to feel better?

If you experience any vaginal bleeding during postmenopause, contact your healthcare provider to rule out a serious medical condition.

How Often Do I Need To See My Doctor After Menopause

You should still see your healthcare provider for routine gynecological care even though you aren’t menstruating. This includes Pap tests, pelvic exams, breast exams and mammograms. You should continue to schedule annual wellness appointments. Since you are at an increased risk for osteoporosis, providers usually recommend bone density screenings as well. Talk to your healthcare provider to determine how often you should make check-up appointments based on your health history.

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What Is The Most Profound Change You Will Experience

Being told you may need a hysterectomy is a difficult and deeply emotional experience because it means your menstrual periods stop, and you wont be able to get pregnant. Dr. Macey only recommends a hysterectomy when all other treatment options have been considered tried, if possible and failed to improve your symptoms.

The most common health conditions treated with a hysterectomy — uterine fibroids, endometriosis, abnormal uterine bleeding, and uterine prolapse — can often be treated with procedures that preserve your uterus, but it depends on the severity of your problem and your overall health. If you have cervical cancer, uterine cancer, or severe uterine hemorrhage, hysterectomy may be the best choice for your health.

Removal Of The Ovaries

Why Am I Spotting Years After a Partial Hysterectomy?

The National Institute for Health and Care Excellence recommends that a woman’s ovaries should only be removed if there’s a significant risk of associated disease, such as ovarian cancer.

If you have a family history of ovarian or breast cancer, removing your ovaries may be recommended to prevent you getting cancer in the future.

Your surgeon can discuss the pros and cons of removing your ovaries with you. If your ovaries are removed, your fallopian tubes will also be removed.

If you have already gone through the menopause or you’re close to it, removing your ovaries may be recommended regardless of the reason for having a hysterectomy.

This is to protect against the possibility of ovarian cancer developing.

Some surgeons feel it’s best to leave healthy ovaries in place if the risk of ovarian cancer is small for example, if there’s no family history of the condition.

This is because the ovaries produce several female hormones that can help protect against health problems such as weak bones . They also play a part in feelings of sexual desire and pleasure.

If you’d prefer to keep your ovaries, make sure you have made this clear to your surgeon before your operation.

You may still be asked to give consent to treatment for having your ovaries removed if an abnormality is found during the operation.

Think carefully about this and discuss any fears or concerns you have with your surgeon.

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The Female Reproductive System

The female reproductive system is made up of the:

  • womb a pear-shaped organ in the middle of your pelvis where a baby develops the lining of the womb is shed during a period
  • cervix the neck of the womb, where the womb meets the vagina the cervix is the lower part of the womb and not separate
  • vagina a muscular tube below the cervix
  • fallopian tubes tubes that connect the womb to the ovaries
  • ovaries small organs by the fallopian tubes that release an egg each month

Page last reviewed: 01 February 2019 Next review due: 01 February 2022

What Are The Different Types Of Hysterectomy

There are several types of hysterectomy that can be performed, depending on the reason for your surgery.

These include:

  • Total hysterectomy: the uterus and cervix, but not the ovaries, are removed. This is the most common type of hysterectomy.
  • Subtotal hysterectomy: the uterus, but not the cervix or ovaries, are removed. This type of hysterectomy is less common, as there is still a risk of cervical cancer if the cervix is left in place.
  • Hysterectomy with oophorectomy: the uterus and cervix, and one or both of the ovaries, are removed.
  • Hysterectomy with Salpingo-oophorectomy: the uterus, one or both of your ovaries, and your fallopian tubes are removed.
  • Radical hysterectomy: the uterus, cervix, ovaries, fallopian tubes, part of your vagina, lymph glands, and fatty tissue are removed.

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What Causes Postmenopausal Bleeding

Vaginal bleeding during postmenopause isn’t a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.

Managing Surgical Menopause Symptoms

Menopause: Symptoms, causes, and treatments

To reduce negative side effects of surgical menopause, doctors may recommend hormone replacement therapy. HRT counteracts the hormones youve lost after surgery.

HRT also lowers the risk of developing heart disease and prevents bone density loss and osteoporosis. This is especially important for younger women who have removed their ovaries before natural menopause.

Women younger than 45 who have their ovaries removed and who arent taking HRT are at an increased risk of developing cancer and heart and neurological diseases.

However, HRT has also been associated with an increased risk of breast cancer for women with a strong family history of cancer.

You can also manage your surgical menopausal symptoms through lifestyle changes that help to reduce stress and alleviate pain.

Try the following to reduce discomfort from hot flashes:

  • Carry a portable fan.

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